(Total Colectomy; Partial Colectomy; Colon Removal)

Definition

This is a procedure to remove all or part of the colon. The colon, or large intestine, is the lower part of the intestinal tract. In a partial colectomy, only part of the colon is removed. In a total colectomy, all of the colon is removed.

For colon cancer, the goal is to remove all of the cancer. If you have a precancerous condition, then you may have prevented the development of cancer. If you had surgery due to other conditions, a successful operation will alleviate or improve your symptoms.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

Your doctor may recommend preparation several days in advance of your procedure. This may include:

A special diet.

Your colon must be completely cleaned out. A number of cleansing methods may be used. This may include enemas, laxatives, and a clear-liquid diet. You may be asked to drink a large container of solution. It will aid in the complete emptying of the colon. This preparation may start several days before the procedure.

Antibiotics. It is important to take them as directed.

A shower the night before your procedure using antibacterial soap.

Wearing comfortable clothing.

Arranging for a ride to and from the hospital.

Arranging for help at home for the first days after your procedure.

Anesthesia

Description of Procedure

Partial Colectomy

A single, long incision will be made in the abdomen. The diseased portion of intestine will then be removed through the incision. The two loose ends of intestine will be sewn together. Some soft tubes may be left in the abdomen to drain any accumulating fluids.

Stitches or staples will be used to close the area. A bandage will be placed over the incisions.

Total Colectomy

In a total colectomy, the entire colon will be removed through the incision. In some cases, the last part of the small intestine, called the ileum, is then connected to the rectum. A small pouch is made from the ileum to store stool. This pouch mimics the function of the rectum and preserves anal function.

Stitches or staples will be used to close the area. A bandage will be placed over the incisions.

Colostomy

With either procedure, you may need a colostomy or ileostomy. In this procedure, an artificial opening will be created in your abdomen, called a stoma. One or both ends of the intestine will be attached to the stoma. This allows feces to exit your intestine through the stoma. It collects in a pouch called an ostomy bag. A colostomy may be temporary or permanent.

A temporary colostomy allows the intestine to rest and heal. When your intestine has healed properly, you will undergo another operation to rejoin the ends of the intestine.

Colostomy Pouch

Immediately After Procedure

The removed tissue will be sent to a lab for examination. You will be taken to the recovery room and monitored.

How Long Will It Take

About 1-4 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is 5-6 days. Your doctor may choose to keep you longer if complications occur.

Post-procedure Care

At the Hospital

You may need antibiotics. You may also need medication for nausea and pain.

You may require a nasogastric (NG) tube for a few days. The tube enters through your nose and goes to your stomach. It is used to help decompress your intestines.

Your intestine will require some time to heal before it will function properly again. At first, you will get nutrition through an IV. As you improve, you will be slowly advanced through liquid and soft diets to a regular diet.

If you had a colostomy or ileostomy, a pouch will be attached on the outside of your body. Waste material will be collected in it.
You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating.

You will wear boots or special socks to help prevent blood clots.

You will be asked to walk often after surgery.

You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will improve lung function.

Your incision will be examined often for signs of infection.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

Washing their hands

Wearing gloves or masks

Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

Washing your hands often and reminding your healthcare providers to do the same

Reminding your healthcare providers to wear gloves or masks

Not allowing others to touch your incision

At Home

If you have a colostomy:

You will need to take it easy for 1-2 months.

A specialized nurse will teach you how to care for the stoma site and change the
ostomy bag
.

Ask your doctor about when it is safe to shower, bathe, or soak in water.

You will progress from a clear liquid, to a bland, low-fiber diet, to your regular diet after about 6-8 weeks.

Alert your physicians and pharmacist that you cannot take medications that are considered time-released or time-sustained.

Do not use laxatives, because postcolostomy stools are usually quite liquid.

Drink plenty of liquid daily as extra fluids will be lost in your stool.

You will need to practice good skin care of the area around the stoma. This will help to prevent inflammation and infection.

You may wish to join a support group or seek counseling to help you adjust to your colostomy.

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.